Evidence map›Paper›PMID 28264833›Full record

Observational studyBMJ open2017

Impact of gender on event rates at 1 year in patients with newly diagnosed non-valvular atrial fibrillation: contemporary perspective from the GARFIELD-AF registry.

A John Camm, Gabriele Accetta, Wael Al Mahmeed, Giuseppe Ambrosio, Samuel Z Goldhaber, Sylvia Haas, Petr Jansky, Gloria Kayani, Frank Misselwitz, Seil Oh and 6 more

Registry-linked trialOpen access · goldAbstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01090362 (Prospective, Multi Centre, International Registry of Male and Female Patients Newly Diagnosed With Atrial Fibrillation.), which is not on this map. Cited by 18 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 2 pooled it
3.4field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01090362 completednot on this map

Prospective, Multi Centre, International Registry of Male and Female Patients Newly Diagnosed With Atrial Fibrillation.

TypeobservationalSponsorThrombosis Research InstituteRan2009 to 2020Enrolled57,250ConditionsAtrial Fibrillation
3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 2 syntheses or guidelines pooled it, 35 citations in OpenAlex.

  1. Guideline
  2. Pooled it
  3. Article
  4. Article
  5. Is the association between cognitive disease progression and atrial fibrillation modified by sex?Alzheimer's & dementia : the journal of the Alzheimer's Association · 2023
    Article
  6. Article
  7. Review
  8. Article
  9. Article
  10. Observational
  11. Women and atrial fibrillation.Journal of cardiovascular electrophysiology · 2021
    Review
  12. Article
  13. Observational
  14. Review
  15. Review
  16. Article
  17. Article
  18. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 11 institutions in 9 countries.

A John CammSt George's University of London, and Imperial College, London, UK.
Gabriele AccettaThrombosis Research Institute, London, UK.
Wael Al MahmeedHeart and Vascular Institute, Cleveland Clinic, Abu Dhabi, United Arab Emirates.
Giuseppe AmbrosioUniversity of Perugia School of Medicine, Perugia, Italy.
Samuel Z GoldhaberHarvard Medical School, Boston, USA.
Sylvia HaasFormerly Technical University of Munich, Munich, Germany.
Petr JanskyMotol University Hospital, Prague, Czech Republic.
Gloria KayaniThrombosis Research Institute, London, UK.
Frank MisselwitzBayer HealthCare Pharmaceuticals, Berlin, Germany.
Seil OhSeoul National University College of Medicine, Seoul, Republic of Korea.
Ali OtoHacettepe University, Ankara, Turkey.
Pekka RaatikainenTampere University Hospital, Tampere, Finland.
Jan SteffelUniversity Hospital Zurich, Zurich, Switzerland.
Martin van EickelsBayer HealthCare Pharmaceuticals, Berlin, Germany.
Ajay K KakkarThrombosis Research Institute, London, UK.
GARFIELD-AF Investigators
Thrombosis Research Institute · GBBayer (Germany) · DEHacettepe University · TRHarvard University · USSeoul National University · KRSt George's, University of London · GBTampere University Hospital · FITechnical University of Munich · DEUniversity Hospital in Motol · CZUniversity Hospital of Zurich · CHUniversity of Perugia · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesGlobal Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) explored the impact of gender, risk factors and anticoagulant (AC) treatment on 1-year outcomes in patients with non-valvular atrial fibrillation (NVAF).

designGARFIELD-AF is a prospective non-interventional registry.

settingInvestigator sites (n=1048) are representative of the care settings/locations in each of the 35 countries.

participantsPatients ≥18yrs with newly diagnosed (≤6 weeks' duration) NVAF and ≥1 investigator-determined stroke risk factors.

main outcome measuresEvent rates per 100 person-years were estimated from the Poisson model and HRs and 95% CIs calculated.

resultsOf 28 624 patients (women 44.4%; men 55.6%) enrolled, there were more elderly (≥75 years) women (46.9%) than men (30.4%). All-cause mortality rates per 100 person-years (95% CI) for women and men were 4.48 (4.12 to 4.87) and 4.04 (3.74 to 4.38), respectively, stroke/systemic embolism (SE) (1.62 (1.41 to 1.87) and 1.17 (1.01 to 1.36)) and major bleeding (0.93 (0.78 to 1.13) and 0.79 (0.66 to 0.95)). After adjustment for baseline risk factors in treated and untreated patients, HRs (95% CI) for women (relative to men) for stroke/SE rates were 1.3-fold higher in women (HR 1.30 (1.04 to 1.63)), and similar for major bleeding (1.13 (0.85 to 1.50)) and all-cause mortality (1.05 (0.92 to 1.19)). Antithrombotic treatment patterns in men and women were almost identical. 63.8% women and 62.9% men received AC± antiplatelets. Relative to no AC treatment, the reduction in stroke/SE rates with AC treatment was greater (p=0.01) in men (HR 0.45 (0.33 to 0.61)) than women 0.77 (0.57 to 1.03). All-cause mortality reduction with AC treatment was similar (women: 0.65 (0.54 to 0.77); men: 0.57 (0.48 to 0.68)). The risk of major bleeding when treated with AC versus no AC was 2.33 (1.41 to 3.84) in men and 1.86 (1.16 to 2.99) in women (p value=0.53).

conclusionsWomen have a higher risk of stroke/SE and the reduction in stroke/SE events rates with AC treatment is less in women than in men. TRIAL REGISTRATION NUMBER: NCT01090362.

Indexed as

AgedAnticoagulantsAtrial FibrillationFemaleFollow-Up StudiesHumansMaleMiddle AgedProspective StudiesRegistriesRisk FactorsSex FactorsTreatment OutcomeAnticoagulantsGenderNon-valvular atrial fibrillationStroke rate

Identifiers

PMID28264833
PMCPMC5353285
OpenAlexW2592877210

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.